Long term goal: The goal of the proposed public health informatics research project is to implement and[unreadable] evaluate a model electronic health record (EHR) clinical decision support system based on both clinical[unreadable] indicators and public health goals. The project is being led by the Institute for Urban Family Health, a[unreadable] community health center (CHC). Since 2001, the Institute has implemented an EHR at its network of 13 fulltime[unreadable] ambulatory sites to improve the quality and outcomes of care provided to approximately 70,000 patients[unreadable] annually. It is the first free-standing CHC in New York City - and one of only a few nationally - to do so.[unreadable] Specific aims: This project will develop and assess the strengths of a model EHR for public health by[unreadable] enacting three intervention components that: (1) evaluate the utility EHR clinical decision supports for each[unreadable] of ten Take Care New York (TCNY) public health priority areas; (2) assess the effectiveness of three EHR[unreadable] clinical decision support "use cases" that are informed by epidemiological data; and (3) evaluate methods for[unreadable] automated two-way transfer of data between the citywide immunization and lead registries and an EHR[unreadable] Rationale: A growing body of literature points to the role that clinical decision support systems (CDSS)[unreadable] play in improving patient care and health outcomes, but fails to examine both the clinical and public health[unreadable] value of incorporating epidemiological data and public health priorities into these systems. The researchers[unreadable] seek to promote sound theory and application of electronic CDSS by integrating demographic[unreadable] characteristics, pervasive conditions represented by the TCNY goals, and health information with a[unreadable] traditional clinical knowledge base.[unreadable] Methods: The proposed study will use a host of research measures, including a series of clinical[unreadable] intervention metodologies capturing patient and provider adherence, provider surveys, and epidemiological[unreadable] and clinical inidcators analyses. The protocol will be designed and implemented by project staff in[unreadable] partnership with the New York City Center of Excellence in Public Health Informatics partners.[unreadable] Public Health and Technological Value: The project will develop a model EHR for public health that[unreadable] produces, transfers, and applies locally relevant, evidence-based knowledge. Lessons learned will extend[unreadable] traditional EHR uses, resulting in improved clinical care tools and public health response capability.